# 13075 BLACKBIRD STREET OPCO, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Alta Gardens Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497512693
- **Authorized official:** AVROHOM TRESS (MANAGER OF BOLD QUAIL 3 OPERATIONS)
- **Authorized official phone:** (310) 730-4800

## Contact information

- **Practice address:** 13075 BLACKBIRD ST, GARDEN GROVE, CA 92843-2902
- **Practice address phone:** (714) 530-6322
- **Mailing address:** 9526 W PICO BLVD, LOS ANGELES, CA 90035-1202
- **Mailing address phone:** (310) 730-4800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 03/04/2024
- **Last updated:** 03/04/2024